Welcome to Menopause: Be Prepared for UTI

Urinary tract infections (UTIs) are among the most common infections women face, but did you know that postmenopausal women are 55% more likely to develop them?

Hormones play a significant role in this increased risk. As women age, they experience a decline in estrogen, leading to thinner tissue and weakened muscles in the urethra and vagina. This hormonal change, coupled with a decrease in healthy bacteria, creates an environment where harmful bacteria can thrive. Additionally, the female anatomy contributes to the higher UTI rates; women have shorter urethras, which means bacteria have a shorter distance to travel to the bladder.

Approximately 20-36% of postmenopausal women experience recurrent UTIs, defined as two or more infections within six months or three or more within a year. There is also a growing concern about drug-resistant strains of UTIs. A 2022 World Health Organization report, which analyzed data from 87 countries, found that over 20% of UTIs were resistant to first and second-line antibiotics due to the prevalence of E. coli bacteria.

The good news is that a new treatment option, Pivmecillinam (Pivya), will soon be available for women in the U.S. This oral antibiotic has been used in Europe for over 40 years and received FDA approval in April. It boasts a 95% effectiveness rate in treating UTIs and is recommended as a first-line treatment in several countries.

Common UTI symptoms include a burning sensation during urination, cloudy or foul-smelling urine, and a frequent urge to urinate. More severe cases may present with blood in the urine or back pain. Risk factors also include diabetes and urinary incontinence.

While not all UTIs can be prevented, here are some tips to help reduce your risk:

• Stay hydrated by drinking plenty of water.
• Urinate before and after sexual activity.
• Opt for showers instead of baths.
• Wipe from front to back after using the restroom.
• Avoid douches, sprays, or powders.

Pivmecillinam is expected to be available in the U.S. in early 2025, and an intravenous version is also being developed for use in hospitals for more severe cases. Although cranberry juice or extract has long been thought to prevent or treat UTIs, studies have shown little evidence to support this. If you experience UTI symptoms, it’s crucial to consult a doctor promptly. Untreated infections can spread quickly to other parts of the body, leading to more serious health issues.